Contrary to popular belief, people with tattoos really do care what others think of them, especially women.

According to a report in the July issue of Archives of Dermatology more women than men visit dermatology clinics for tattoo removal and maybe motivated by the social stigma associated with tattoos and negative comments by others. About one-fourth of adults age 18 to 30 have a tattoo.

"While the vast majority of individuals who are tattooed are pleased with their skin markings (up to 83 percent), the popularity and prevalence of tattoos often mean that dermatologists are increasingly hearing stories of regrets and requests for tattoo removal," the authors write. About 20 percent of those with tattoos are thought to be dissatisfied with their artwork, although only about 6 percent seek removal.

Researchers from the Texas Tech University Health Sciences Center, Lubbock, Texas, conducted a survey of 196 individuals who visited one of four dermatology clinics for tattoo removal in 2006. The 66 men and 130 women, with an average age of 30, answered 127 questions about demographics, obtaining their tattoo and their motivations for seeking removal. Their answers were compared with responses to a similar survey conducted in 1996.

"In both the 1996 and the 2006 studies, a shift in identity occurred, and removal centered around dissociating from the past," the authors write. In 2006, participants reported they had gotten a tattoo to feel unique (44 percent), independent (33 percent) or to make life experiences stand out (28 percent).

The main reasons listed for seeking tattoo removal included just deciding to remove it (58 percent), suffering embarrassment (57 percent), lowering of body image (38 percent), getting a new job or career (38 percent), having problems with clothes (37 percent), experiencing stigma (25 percent) or marking an occasion, such as a birthday, marriage or newly found independence (21 percent).

2006 survey also found that participants were more likely to be women (69 percent vs. 31 percent men) who were white, single, college-educated and between the ages of 24 and 39. They reported being risk takers, having stable families and were moderately to strongly religious.

While the women were pleased with their tattoos when they got them, they reported changes in their feelings over the following one to five years. "While men also reported some of these same tattoo problems leading to removal, there seemed to be more societal fallout for women with tattoos, as the tattoos began to cause embarrassment, negative comments and clothes problems and no longer satisfied the need for uniqueness," the authors write.

"Societal support for women with tattoos may not be as strong as for men," they conclude. "Rather than having visible tattoos, women may still want to choose self-controlled body site placement, even in our contemporary society."